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NPI Code Detail

MEDICARE: PATRICIA CARR

MEDICARE: PATRICIA CARR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor4981LA

General Provider Information

NPI Number : 1063887594
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA CARR
Provider Business Mailing Address
First Line : 520 OLIVE ST
Second Line : STE. 201
City : SHREVEPORT
State : LA
Zip : 71104-2312
Country : US
Telephone Number : 318-429-7500
Fax Number : 318-227-6179
Provider Business Practice Location Address
First Line : 520 OLIVE ST
Second Line : STE. 201
City : SHREVEPORT
State : LA
Zip : 71104-2312
Country : US
Telephone Number : 318-429-7500
Fax Number : 318-227-6179
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2015
Last Update Date : 12/09/2015

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Directions to “ PATRICIA CARR ” Practice Location

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